Medicaid and CHIP - Initially Enrolling Providers

Medicare and Medicaid Program; Program Integrity Enhancements to the Provider Enrollment Process (CMS-10576)

OMB: 0938-1304

IC ID: 220373

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Medicaid and CHIP - Initially Enrolling Providers
 
No New
 
Required to Obtain or Retain Benefits
 
42 CFR 455.107(b)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

56,250 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 56,250 56,250 0 0 0 0
Annual IC Time Burden (Hours) 562,500 562,500 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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